Accredited Exercise Physiology – Apparently healthy practicum logbook Date Number
of hours Case description Description of services Supervisor
name
Supervisor’s signature
Applicant’s signature
2/3/12 3 hrs
(Client 1) 27 yo female New gym membership, using free PT session to
design program 1 hr F2F 2 hrs prep
F2F- Initial assessment – ESSA pre-screening tool. 5 yrs ago ankle injury playing netball, no problems since. No other flags
identified- client is classed as apparently healthy.
Ex history- walking dogs 6 months, gym membership for 3 months 2 years ago.
Goals- tone up for wedding in 6 months.
Fitness testing- YMCA submax test, push ups- maximal reps in 30 seconds, plank- max time.
Prep-
Set up tests & reviewed test results.
Set a 6 month plan- 2 month program written, fitness tests to be conducted every 2 months for progress. Test results will be used to determine goals for next 2 month block- e.g. increase plank hold to 45 seconds after 2 months, then to 90 seconds after 4 months.
Developed and designed next 2 exercise sessions involving combination of machine aerobic and bodyweight resistance exercises. Reviewed programs with supervisor who recommended incorporating more functional compound exercises and reducing
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Goal- tone up for wedding
F2F- 4 hours
Implemented exercise program consisting of treadmill/upright bike warm up followed by intervals. Resistance program consisted of basic bodyweight exercises such as squats, lunges, push ups and crunches.
Progression involved adding weight to squats in 3rd session, and increasing the incline on treadmill intervals.
Client’s motivation wasn’t very high, so focussed on positive feedback and education about the purpose of the program. Encouraged client to start incorporating jogging intervals when walking dogs to speed up progress.
Client increased max plank by 10 seconds, and max push ups by 5 reps.
J.Doe J Doe F Bueller
10/4/12-11/4/12
14
Group of 24 male second division AFL players
Aged 17-32 Goal- Increase fitness for
upcoming season F2F- 8 hours (testing and delivery of warm up & cool down with intention to prescribe exercise intervention)
Prep- 6 hours (writing programs)
(Total 14 hours)
Pre season fitness camp. My role involved performing a series of fitness tests on each player, and collating results to help design group and individual pre-season training sessions.
Face to Face- Testing participants on the following activities: height, weight, body composition, agility, vertical jump, flexibility, muscular strength, muscular endurance and aerobic fitness (beep test). I was responsible for performing appropriate warm up and cool down activities across the sessions to prevent injuries- including stretching routines. (8 hours)
Example 1, male 30 yo performed in average range for all tests except body composition and sit and reach for flexibility. After questioning client he advised a previous season hamstring strain, followed by no exercise over the off-season. Determined that this season he would need to perform longer warm ups and cool downs to prevent injury, and prescribed a home exercise program of lower body stretches to complement the 3x weekly team training sessions.
Example 2, male 17 performed above average in agility, flexibility & aerobic fitness, but slightly below average on muscular strength & endurance. This player’s gym based program was initially adapted to focus more on strength with machine based upper and lower body exercises predominantly, with a
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Preparation- Set up of tests, collation of exercise test results, planning of pre-season training sessions, identifying specific needs from fitness test results and planning for injury prevention in conjunction with senior coach. (6 hours)
Exercise delivery: Group 1- A group of 5-10 active mothers (41-52 YO) training
after kids finish school for 45 min/session during most
school weeks. General group aims are to improve
pelvic floor, increase cardiovascular fitness and
increase strength.
e.g. 45 YO female. Long history of sport and
exercise. Has lost considerable fitness after
latest child. Aims to increase general fitness and
improve pelvic floor function.
F2F- 10x1 hr PT sessions (total 10 hrs)
Conducted pre-screening questionnaires. Tested BP, HR, weight, waist circumference, hip circumference, sit and reach test and 6 minute run test (assessment hours not included in log book) for all clients. I took each member of the group through a FMS and recorded the results. I conducted similar assessments every 5-6 weeks. Fitness testing was conducted over the first 2 sessions. This included 10 minutes run for distance, max push ups in a minute, max squats in a minute, max plank hold, agility course time, 1 km for time.
I took the group through 45 minute sessions during most school weeks of term. Before each session group was asked about any new injuries or issues.
Sessions usually include group resting HR taking. Group warm up of a gradual walk to run over 5-8 minutes.
The following general mesocycles and example sessions were completed.
Weeks 1-3: Walk/run intervals. Boxing. Resistance circuits (20 sec per exercise). Pelvic floor activation and exercises in supine positions. Core stability.
E.g. 5 minute walk/run warm up. Boxing circuit 30 secs per station for 10 minutes. Resistance circuit: 1 minute per station battling rope, theraband row, knees on boxing pad, squat, bench dips, dumbbell curl and press, agility course. Pelvic floor/core: PF/TA activations and holds, planks. Stretching 2 x 15 secs per muscle group.
Weeks 3-5: Fartlek intervals. Boxing. Body weight resistance circuits. Pelvic floor exercises. Core strength exercises.
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Weeks 5-7: Sprint intervals and long slow runs. Boxing. Functional resistance exercises. Pelvic floor exercises. Core strength.
Weeks 5-9: Agility drills. Sprint intervals. Boxing. Pelvic floor exercises. Core stability.
Rationale: The above exercise programs were based on groups goals, ability and training preferences. The high intensity cardio and circuit training was included to assist in weight/fat loss. These methods have been shown to burn large amount of calories which make them suitable for this goal.
Resistance/strength exercises were included to aid the client in improving strength. Research shows weights done at 2-5 sets of 6-12 reps will build strength and muscular endurance as well as assist in weight loss. Impact exercises such as jump downs were included to assist in maintaining and increasing bone mineral density. Balance exercises were included to maintain and improve balance. Stretching was included to maintain ROM, prevent injuries and increase flexibility. Sessions and exercises were regressed if individual clients were unable to perform certain exercises with good technique. For example client was unable to perform full push ups so knee push ups were used instead. Sessions were progressed as each client’s fitness and ability improved. This included increasing session’s intensity (faster drills, heavier weights), decreasing rest periods and increasing difficulty (stability exercises, complex plyometrics, hill sprints).
Accredited Exercise Physiology – Cardiopulmonary/metabolic practicum logbook Date
Number of hours
Case description Description of services Supervisor name smoker (30 pack-years) with coronary artery stent of circumflex artery, previous angioplasty of LAD, hypertension and Type 2 diabetes.
Goal –Weight loss, exercise intervention for the purpose of initially managing obesity
F2F- 1.5 hrs
Performed Initial Assessment –took relevant medical and exercise histories, medical and allied health treatments including medication
management. Client had completed hospital based cardiac rehab course 1 year ago, and complied with home program well for 3 months before losing motivation.
Discussed patient exercise capacities, goals, opportunities and barriers for exercise participation.
Identified safe exercise limits and effective exercise ranges via RHR, BP, 6-minute walk test with RPE and HR monitor.
Performed 30s sit-to-stand, and 30s wall push-up test.
Gave patient National Physical Activity Guidelines for reading, and made a follow-up appointment for 1 wks time.
A.Beast A.Beast F Bueller
3/3/12 1 Preparation-- 52 yr obese male, smoker (30 pack-years) with coronary artery stent of circumflex artery, previous angioplasty of LAD, hypertension and Type 2 diabetes.
.
Goal –Weight loss, exercise intervention
My practicum supervisor gave me the task to research the medications taken by this client and how they may affect his exercise capacity, particularly in regards to how an AEP needs to
monitor sessions. A.Beast A.Beast F Bueller
Client was also on Novo rapid, which as a synthetic form of insulin tends to increase the likelihood of hypoglycaemic episodes. Education on hypoglycaemia prevention & management will be discussed with client prior to commencing next exercise session- e.g. the importance of having a hypo kit at all times.
4/6/12 1 Preparation - 58 year old female, non-smoker, diabetes.
Goal – Diabetes management Prep- 1 hr
Reviewed assessment information in client file.
Prepared exercises to be prescribed for patient’s home program to improve diabetic management.
Patient had little home equipment, so designed a 30 min circuit incorporating a combination of cardiovascular exercises (e.g. shadow boxing, step ups, high knees) and major muscle group body weight resistance exercises (e.g. squats, wall push ups, bench dips, calf raises). Reviewed with supervisor.
A.Beast A.Beast F Bueller
23/04-10/06/2010 8hrs
Exercise delivery-
52 yrs male farmer, type 2 diabetic, smoker.
He is active and physical due to work demands but has gained 10kg due to poor diet.
On Diabex medication- reports good compliance
Goal- to manage diabetes and weight.
Refer to dietitian F2F- 5 hrs Prep- 3 hrs
Face to Face (5 hours)
Exercise prescription- 5 supervised sessions
Exercise intervention- prescribed exercises/program-
Exercise sessions comprised of a warm up, followed by 30 minutes moderate intensity, steady state cardiovascular exercises (e.g. 20mins jogging, 10mins rowing) and up to 30 minutes of general conditioning (particular focus on upper body as his low body was fairly strong due to work tasks). Upper body exercises included push ups;
low row, bicep curl, and chest fly variations using mainly free weights.
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included prone/supine bridges, abdominal crunch variations, exercise ball back extensions, lifting variations.
Pt program was progressed/changed every 2 weeks- e.g. increased reps from 8-12 for most ball based core strength exercises, and increased upper body weights by 1 bar in the final session.
Client vitals checked (BP, HR and blood glucose) before, during and after sessions to ensure safe exercise limits. Provided education on
hypoglycaemia prevention & management. No adverse incidents experienced.
Preparation (3 hours)
Assessment of client- completed health consultation including health screening/checks, medical & exercise histories, anthropometrical evaluation, fitness test, muscular strength &
endurance assessments, exercise goal setting, diabetes management strategies discussed.
At reassessment every 2 weeks retook
anthropometrics, fitness testing, and reviewed exercise goals.
16/11/09-20/11/09
4
Cardiac Rehabilitation Phase II Clients present with conditions such as:
Angioplasty/Stent/ICD/CABG/Valve
Phase II- cardiac patients attend hospital gym for 45 min sessions 3xweek following a 1 hr education session. Exercises consists of gentle aerobic ex on equipment, followed by resistance program using
body weight, hand weights, theraband. A.Beast A.Beast F Bueller
Main purpose for exercise – cardiac rehab Client #1: 53yo male, angioplasty, ex
smoker, knee arthritis, obese
Client #2: 67 yo female mitral valve replacement, hx of frozen shoulder
Client #3: 68yo male, 4x CABG, spinal stenosis, plated R forearm from # 25 yrs
ago (decreased pronation/supination)
Client #4: 75 yo male, 2x stents, IHD, LBP
F2F- 4 hours
RPE to ensure intensity was appropriate. Client has been attending for 3 weeks, and performed with good technique. No changes to program required this session.
Client 2: Followed client through circuit style program. Client has never performed resistance training before so spent more time on technique and providing education on the benefits of regular resistance exercise- client was interested in affects on bone mineral density as her mother suffered osteoporosis.
Client 3: Followed client through circuit style program. Resistance training adapted to account for decreased shoulder pronation/supination - e.g. unable to perform full bicep curl, so program adapted to hammer curls. Only used recumbent bike due to back pain from spinal stenosis.
Client 4: Client was in final session of phase II, so program was modified to include more compound exercises in readiness for phase III. Focussed on cardio equipment today, trialling 2% incline for 2 mins on treadmill. RPE within acceptable ranges so changed program card to reflect.
Accredited Exercise Physiology – Musculoskeletal/neurological/neuromuscular practicum logbook Date Number
of hours Case description Description of services Supervisor name
Client reported commencing 30 min cycling 5x week, with increased LBP at same time.
Assessed for supine bridge capacity- reduced 10 sec in 1 month.
Regressed program to Pilates style core activation exercises, . Increased recommended hamstring stretches from 3x weekly to daily.
Prep - prep for sessions, researching core stability exercises &
progressions for non-specific LBP
Admin- updating SOAP notes, writing report to GP
A.Beast A.Beast F Bueller
Gathered medical history, current pain levels and goals discussed.
Included the following tests- core activation, STS in 30 sec, glute bridges to failure, and gait assessment.
Discussed posture and adherence for home ex program- adherence was identified as potentially being low. Identified home options for exercise e.g. client has stairs. Have initiated
A.Beast A.Beast F Bueller
17/5/13 1
Supervisor suggested I review the surgery protocol post laminectomy and become familiar with timeframe for rehab.
Reviewed referral letter from orthopaedic surgeon and physio progress notes.
Goal – increase knee stabilisation, balance
Gym program developed and reviewed at 2 & 4 weeks.
Ex Rx goal was to stabilize knee through improvement of quad, particularly VMO. Stretching and balance program developed
& reinforced to improve hamstring length & flexibility.
Wup:
5 mins on recumbent bike Lower body stretches Exercises included:
- Seated core activation on fit ball 20 seconds x 3 - Double leg glute bridges 12reps x 2
- Fit ball squats 10reps x 2
Outcomes: improved ROM in affected knee, improved overall mobility and enjoying exercise program
Preparation 30 mins:
Updated and reviewed case notes
GR Martin GR Martin F Bueller
31/7/13-
02/9/13 7
Female, 72 yo Primary reason for tx:
suffered stroke 8 weeks ago.
Co morbidities:
Hypertension, OA, RA, obesity F2F- 1 hr Prep- 2 hrs
access to facilities. Main goal is to achieve neuromuscular development and assist client to perform ADL’s independently.
Secondary goal is to reduce weight.
Left side is impaired, client feels uncomfortable holding glass this side, now using walking stick & is avoiding stairs.
Performed the following tests
Baseline girth measurements: Including waist measurement (110cm).
Sub maximal test: Graded walking test noting any foot drag, tracking & posture.
Flexibility & ROM tests: include modified sit and reach, shoulder flexibility, hip flexion (mod Thomas test).
Functional testing: sit to stand, TUG, gait assessment, balance test (Berg balance scale), grip strength, abdominal strength test.
Program design (2 hours):
1st macro cycle is designed to develop safe correct technique with compound exercises to mobilise large muscle tissue and develop aerobic CV system. Increase muscle strength/joint stability and ROM with particular emphasis on left side.
Emphasis will be on targeting core abdominals and posture control, as well as improving sensory feedback using mirrors, sense of touch & sequential learning tasks to assist in neuro-plasticity and regaining neuromuscular control and function.
Ongoing stretching & flexibility is also prescribed.
Undertook 4x1 hr sessions with client. Each session consisted
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client to dietitian.
Program will be reviewed after 3 more sessions.
1/3/13 1
Pain Management Clinic Team Meeting
Admin- 1 hr
Team meeting held 1x week with AEP, Physio, OT, nurse, psych
& prac students. Reviewed progress of participants and discussed any barriers to participation. Case study- presentation on CPRS.
A.Beast A.Beast F Bueller
Accredited Exercise Physiology – Other Practicum/Work Experience Logbook
Date Number
of hours Case description Description of services Supervisor name
Supervisor’s signature
Applicant’s signature
23/12/2013 3
Cardiac Stress Test:
3x 1 hr appointments Client 1: 55 yo female with 3 week hx of intermittent chest pain.
Client 2: 69 yo male 2 years post non-STEMI.
Reviewed yearly.
Client 3- 72 yo male w/ 5 yr hx atrial fibrillation well controlled by medication until 3 months ago.
Located at XYZ Hospital.
Test purpose – determine cardiovascular function through treadmill based cardiac stress test.
The test protocol I implemented for all clients was as follows
- Height, weight and BP were taken and recorded in chart.
-Protocol explained, and explained reasons why we may stop the test.
-Applied electrodes for 12 lead ECG to client.
-Placed client on treadmill & attached to equipment.
-Manual Bruce protocol implemented.
-Client disconnected from all equipment
-Test results collated & presented to cardiologist.
Client 1: Test was completed fully with no aberrant rhythms detected.
Client 2: Test was ceased at 6 min mark by client due to claudication. Heart rate was not increased enough to achieve clinically significant test results.
Dr B Honeydew Dr B
Honeydew F Bueller
9/4/12 - 11/5/12
5
60 year old female, 6 months remission from breast cancer Wrote to GP for clearance prior to commencing.
F2F- 4 hrs exercise delivery,
Prep- 1 hr writing to GP
Reviewed physiotherapy exercise program given at hospital during admission. Client reports completing this at home unsupervised regularly for last 6 months, but wishes to progress in strength & endurance.
Client is attending 2 x 30 min supervised sessions per week in a gym setting.
Ex Rx: Sessions focus on upper and lower body strength mainly using compound exercises.
Exercises included- 5 min upright bike warm up, FB squats, calf raises, FB crunches, leg press, and hamstring curl. Client encouraged to perform 5-10 minute cardio cool down and generic stretching sheet post session. Extra care taken with chest exercises, started initial sessions with therabands (e.g. low row
& chest press) and graduated to machine weights (seated row & chest press machine) in the final session as the client tolerated additional resistance.
Monitored using RPE regularly throughout session.
Good compliance and adherence to program.
Regular lifestyle advice given throughout sessions re:
general healthy eating guidelines and encouraged client to start own cardio exercise starting with walks around her block – using the talk test as her gauge and starting with 5 mins. Recorded home based progress in PA diary which was reviewed weekly to discuss barriers, motivation and progress.
Outcomes: Client built to 3x15 min walks per week at the end of the block of sessions. Commenced with 2x8
A.Beast A.Beast F Bueller
4/6/12-9/11/12
Previous hx of MVA causing chronic of chronic fatigue and
non-specific low back pain.
F2F- 2 hrs
Supervisor is registered with DEEWR. Assessing individual’s ability to perform tasks and duties through a work capacity assessment to assist
matching the individual up with suitable employment.
JCA’s refer people with disabilities and other barriers to work to appropriate employment and support services, and their reports are used for Centrelink decisions about capacity to work.
We completed a comprehensive assessment of people’s ability to work and participate in programs of assistance including:
• identifying barriers to participation,
• recommending interventions to help overcome these barriers,
• assessing the impact of medical conditions on ability to work,
• identifying any employment support requirements, and
• direct referral to programs of assistance wherever possible.
Client #1- Significant barrier to work was psych issues, so client referred to counselling services.
Client #2- Client referred to work hardening program with AEP to improve core strength and general endurance to cope with part time retail work.
Prep- review of testing procedures including
A.Beast A.Beast F Bueller
4/3/13 1.5 hrs
40yo male, clinical depression
Purpose of treatment:
Attending upon GP &
psych
recommendation to assist with managing depression & increase social exposure.
F2F- 1 hr Prep- 0.5 hrs
written by an AEP.
I monitored the client through the circuit via his personal HR monitor.
Exercises consisted of hand weight resistance
exercises such as bicep curls, Bosu balance, stairs, and bench weights (bent over row, chest fly, and lat pullover). Reviewed weights & was able to increase bent over row by 2kg.
Provided regular positive feedback, and encouraged interaction with other participants.
Provided correction on technique, and education on use of HR monitor.
Prep: Research into anti-depressant medication &
affects on exercise capacity. I reviewed assessment &
progress notes prior to session
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